926 N.W.2d 472
S.D.2019Background
- Nehemiah Larimer (age 18) died after colliding with a car while riding his 49cc moped; the at-fault driver’s insurer paid its $100,000 limits.
- Nehemiah was an insured under his parents’ American Family Car and Umbrella policies; the moped was not listed as an insured vehicle.
- The Car policy included an Underinsured Motorists Coverage Endorsement; the Umbrella provided excess UM/UIM "no broader than the underlying insurance."
- American Family denied underinsured motorist (UIM) benefits relying on an "owned but not insured" exclusion that bars UIM when injury occurs "while occupying ... a motor vehicle that is not insured under this policy, if it is owned by you or any resident of your household."
- Circuit court granted summary judgment to Larimer, finding the policy ambiguous about whether an unlicensed moped qualified as a covered "motor vehicle;" American Family appealed.
Issues
| Issue | Plaintiff's Argument (Larimer) | Defendant's Argument (American Family) | Held |
|---|---|---|---|
| Whether the Endorsement’s definition of “motor vehicle” and the owned-but-not-insured exclusion are ambiguous | Definitions across the policy should be read together; the endorsement is ambiguous as to whether an unlicensed moped is a "motor vehicle," so exclusion should not apply | Endorsement’s plain definition of "motor vehicle" includes mopeds, so the exclusion clearly bars coverage | Ambiguous — court construed ambiguity against insurer and held exclusion did not apply to Nehemiah’s unlicensed moped |
| Whether the owned-but-not-insured exclusion is void as against public policy (notice of review) | Argues exclusion defeats SDCL 58-11-9.5’s purpose to protect insureds injured by underinsured drivers | Insurer defends the exclusion as a permissible, clear contractual limitation | Court did not decide: because it found the policy ambiguous and resolved in insured’s favor, it declined to reach the public policy question (concurring opinion would find the exclusion void) |
Key Cases Cited
- Harvieux v. Progressive N. Ins. Co., 915 N.W.2d 697 (S.D. 2018) (summary-judgment review standard and de novo review of insurance issues)
- Oxton v. Rudland, 897 N.W.2d 356 (S.D. 2017) (no deference on appellate review of summary judgment)
- Ass Kickin Ranch, LLC v. N. Star Mut. Ins. Co., 822 N.W.2d 724 (S.D. 2012) (ambiguities in insurance contracts construed for the insured; insurer bears burden to prove exclusions apply)
- State Farm Fire & Cas. Co. v. Harbert, 741 N.W.2d 228 (S.D. 2007) (insurer meets burden when claim clearly falls outside coverage)
- Cornelius v. Nat’l Cas. Co., 813 N.W.2d 167 (S.D. 2012) (genuine uncertainty in meaning creates ambiguity resolved for insured)
- Lowery Constr. & Concrete, LLC v. Owners Ins. Co., 901 N.W.2d 481 (S.D. 2017) (entire policy must be examined when interpreting terms)
- Phen v. Progressive N. Ins. Co., 672 N.W.2d 52 (S.D. 2003) (policy exclusions must be consistent with public policy and statutes)
- De Smet Ins. Co. v. Pourier, 802 N.W.2d 447 (S.D. 2011) (majority upheld an owned-but-not-insured exclusion on that case’s facts; noted courts must examine such exclusions in context)
- Wheeler v. Farmers Mut. Ins. Co., 824 N.W.2d 102 (S.D. 2012) (invalidated an owned-but-not-insured exclusion as applied to uninsured motorist coverage)
